Transbronchial Palmaz stent placement for tracheo-bronchial stenosis.
OBJECTIVE
Evaluation of the efficacy of transbronchial Palmaz stent placement in the treatment of tracheo-bronchial narrowing.


METHODS
Twelve patients with stenoses of the tracheo-bronchial tree were treated with balloon-expandable Palmaz stents. Etiology was anastomotic stenosis after lung transplantation (n = 3), bronchogenic carcinoma (n = 2), external compression from thoracic aortic aneurysm (n = 2), Mycobacterium tuberculosis (n = 1), esophageal carcinoma (n = 1), after lobectomy (n = 1), after lobectomy and endobronchial radiation (n = 1), and lye ingestion (n = 1). All patients had respiratory symptoms, radiologic findings of persistent atelectasis, or worsening pulmonary function tests. Bronchoscopy was used to delineate the stenosis prior to intervention. With use of fluoroscopic guidance, stents were placed in the mainstem bronchus (n = 11), lower lobe bronchus (n = 5), bronchus intermedius (n = 5), trachea (n = 3), and middle lobe bronchus (n = 1).


RESULTS
Initial technical success was achieved in all patients. Ten of the 12 patients (83%) had improvement of clinical pulmonary signs or symptoms. During follow-up, five patients died. One was lost to follow-up and was presumed dead. The 30-day mortality rate was 17% (two of 12 patients). The two complications were superficial laceration of the bronchial mucosa during balloon dilation in one patient and compression of stents by a thoracic aortic aneurysm in another patient.


CONCLUSIONS
Initial results suggest that transbronchial Palmaz stent placement is a feasible and effective method of treating tracheo-bronchial stenosis.
Slonim
S M
SM
Section of Cardiovascular and Interventional Radiology, Stanford University Medical Center, California, USA.
Razavi
M
M
Kee
S
S
Semba
C P
CP
Dake
M D
MD
D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001982:Bronchial Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D014135:Tracheal Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome